Best practice guidelines for the management of adverse events associated with amphotericin B lipid complex

Craddock, Charles; Anson, James; Chu, Patrick; Dodgson, Andrew; Duncan, Nick; Gómez, César Alejandro Rojas; Mehta, Jayesh; Sadullah, Shalal; Subudhi, Chinari; Yin, John Liu

doi:10.1517/14740330903418430

Cited by 12 publications

(11 citation statements)

References 36 publications

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“…Several combinations of premedication drugs were used including intravenous rapid acting corticosteroids alone; steroids and paracetamol; steroids, paracetamol, and antihistamines all together. Recent studies have highlighted the importance of premedication regimens combined with a reduction in the infusion rate to minimize, or even prevent, the onset of IRRs, which are based on the administration of systemic corticosteroids, paracetamol, with or without chlorphenamine ( 8 ). The reported incidence of IRRs with ABLC has ranged between 2 and 23% in several studies ( 28 , 29 ).…”

Section: Discussionmentioning

confidence: 99%

“…There was a considerable heterogeneity among the studies, and the major conclusion was that they were comparable except for higher IRRs with ABLC compared to L-AMB ( 7 ). In this respect, Craddock et al ( 8 ) showed a marked decrease in IRRs reaction with ABLC while using premedications along with slow infusion rate, and even recommended a therapeutic algorithm that helps decreasing the rate of IRRs with minimal steroid use ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

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Retrospective Analysis on the Use of Amphotericin B Lipid Complex in Neutropenic Cancer Patients with Suspected Fungal Infections in Lebanon, a Single Center Experience and Review of International Guidelines

et al. 2016

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IntroductionImmunocompromised patients carry a high risk for invasive fungal disease (IFD), which is associated with high mortality.Materials and methodsThis is a retrospective chart review of a 4-year experience of amphotericin B lipid complex (ABLC) utilization for the management of suspected IFD at the Hematology/Oncology and Bone Marrow Transplantation unit at Makassed General Hospital, Beirut, Lebanon between January 2011 and December 2014. We focused on treatment strategy, response rate, and adverse drug events associated with ABLC therapy. We also reviewed ABLC indications in international guidelines beyond its Food and Drug Administration approval.ResultsA total of 89 patients received ABLC therapy for suspected fungal infection. Forty-eight percent were treated for a possible fungal infection, 19% for a problable fungal infection, 12% based on hospital guidelines, and 20% based on treating physician’s recommendations. The overall response rate was 71%. Nephrotoxicity occurred in 24% of patients and serum creatinine improved in 10% of these patients. Moderate hypokalemia was observed in 61% of the patients and severe hypokalemia in 10% but was corrected in both cases. Hepatotoxicity was observed in 12% of the patients throughout ABLC therapy. Infusion-related reactions were observed in 36% of the patients. There was a decrease in the incidence of these reactions upon using combination of premedication drugs.ConclusionIn this study, ABLC proved to be an effective and safe option in the management of suspected IFD in immunocompromised patients failing previous therapies.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Retrospective Analysis on the Use of Amphotericin B Lipid Complex in Neutropenic Cancer Patients with Suspected Fungal Infections in Lebanon, a Single Center Experience and Review of International Guidelines

et al. 2016

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“…Prior to commencing therapy, a test dose is recommended to ensure the patient does not experience a severe hypersensitivity reaction . Pre‐treatment with hydrocortisone and chlorphenamine appears to reduce the incidence of infusion‐related effects . Renal function should be monitored daily on initiation of therapy with amphotericin B, meaning that initiation of therapy may be challenging in the OPAT setting, and a period of hospital admission may be required to initiate therapy.…”

Section: Antifungal Agents Suitable For Opatmentioning

confidence: 99%

Can intravenous antifungal therapy be safely used in the outpatient parenteral antimicrobial therapy (OPAT) setting?

Rae

Kenny

Muldoon

2019

Mycoses

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Summary Outpatient parenteral antimicrobial therapy (OPAT) is an established treatment option for patients with a variety of infections who require a period of intravenous therapy, are clinically stable, and do not require continuous monitoring. Many patients with fungal infections require prolonged therapy due to resistance or intolerance to oral antifungal agents. Despite the widespread use of OPAT by infection specialists, antifungal agents appear infrequently used in this setting. We suggest that with appropriate patient selection, patients with fungal infections could successfully be treated on OPAT.

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“…Mantarların membranına spesifik olup hücre zarındaki ergosterole bağlanıp permeabilite ve transport fonksiyonlarını bozarak fungusit etki gösterir. Oral absorbsiyonu düşük olup, intravenöz olarak kullanılmaktadır [16]. Fakat amfoterisin B' nin nefrotoksisite gibi ağır yan etkileri mevcut olup, vorikonazol gibi daha az yan etkiye sahip yeni antifungal ajanlar geliştirilmişitir [17].…”

Section: Tedaviunclassified

Current Treatment Approaches In Chronic Pleural Empyema Due To Aspergillus Infection

Sapmaz¹

2012

Ann Clin Anal Med

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Aspergilluslu kronik plevral ampiyem nadir görülen, sıklıkla akciğer rezeksiyon ameliyatlarından sonra ortaya çıkan bir komplikasyondur. Plevral aspergillusun etiyolojik faktörleri arasında geçirilmiş veya var olan pulmoner tüberküloz, bronkoplevral fistül, plevral kateterizasyon veya drenaj, akciğer rezeksiyonu, çoklu antibiyotik kullanımı sayılabilir. Bu çalışmada aspergilluslu kronik plevral ampiyem gelişen olgularda medikal ve cerrahi tedavi teknikleri incelenmiştir. Medikal tedavi olarak antifungal ajanlar kullanılır. Cerrahi tedavide tüp torakostomi, açık drenaj (Eleosser fleb, Clagett yöntemi, torakostoma), dekortikasyon, ometum ve/veya ekstratorasik ve abdominal kasların intratorasik transpozisyonu ve torakoplasti gibi geniş bir yelpazeye sahiptir.

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Best practice guidelines for the management of adverse events associated with amphotericin B lipid complex

Abstract: Amphotericin B lipid complex represents a valuable therapeutic option in the treatment of fungal infections but improved strategies for the management of infusion-related adverse events are required.

Cited by 12 publications

References 36 publications

Retrospective Analysis on the Use of Amphotericin B Lipid Complex in Neutropenic Cancer Patients with Suspected Fungal Infections in Lebanon, a Single Center Experience and Review of International Guidelines

Retrospective Analysis on the Use of Amphotericin B Lipid Complex in Neutropenic Cancer Patients with Suspected Fungal Infections in Lebanon, a Single Center Experience and Review of International Guidelines

Can intravenous antifungal therapy be safely used in the outpatient parenteral antimicrobial therapy (OPAT) setting?

Current Treatment Approaches In Chronic Pleural Empyema Due To Aspergillus Infection

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